Erosive Prepyloric Changes-a Manifestation of Stress?

To study the relationship between stress and the endoscopic diagnosis of erosive prepyloric changes (EPC), upper gastrointestinal endoscopy was performed twice in 19 cadets from the Military Academy, once in a 'non-stressed' situation and once after exposure to a standardized stress model. Five biopsy specimens per examination were obtained from the prepyloric mucosa, and the features of acute and chronic inflammation, erosion, and campylobacter-like structures (CLS) were evaluated. The endoscopy showed a significant (p < 0.001) aggravation of EPC after stress. The histologic examination showed an increase of acute inflammation (p < 0.05) and a higher density of CLS (p < 0.01) after stress, as compared with the findings under non-stressed conditions. No association was observed between CLS and EPC. The study sheds new light on the pathogenesis of EPC, as it shows that EPC is aggravated during stress.